Prevalence of lens opacity at Queen Elizabeth Central Hospital in Blantyre, Malawi

Objective: To determine the prevalence of lens opacity in black Africans. Design: A retrospective study. Setting: Eye Ward, Queen Elizabeth Central Hospital (QECH), Blantyre between July and December 1997, Subjects: Case notes of 299 patients aged six months to 84 years with cataracts were studied. Results: Over 90% of the patients were referred from all ten district hospitals in the southern region. Of the 647 patients admitted in the Eye Ward, 299 patients (46.2%) had cataracts - 206 (68.8%) males and 93 females (31.1%), Bilateral cataracts accounted for 61.9%; 22.4% were on the left eye and 15.7% on the right eye. Senility was the leading cause of cataracts in adults, being commonest among unskilled (48.8%) compared to skilled (15.1%) patients, but in children congenital cataracts (53.7%) were the most common. Conclusion: Cataracts accounted for nearly half the admissions in the eye ward. Laterality is reported probably for the first time in Central Africa - bilateral cataracts being more common than unilateral ones, and the leading cause of cataracts in adults was senility whereas congenital cataracts were commoner in children. The prevalence increased with age, males being affected more than females. These findings suggest cataracts as the leading cause of blindness. Community-based studies to determine the prevalence and profile of cataracts are recommended.